“I would try to talk to my doctors about my vanishing self, but they didn’t have much to say on the subject,” Logan said. “Instead they focused on whether I could make eye contact or how much expression I showed in my face.”

Psychiatrist William Sheftner from the Rush University Medical Center explained to Logan that this was typical of doctors who are treating people with mental disorders. The issue of self just isn’t there, he told her, because you’re so preoccupied with whether someone is actually improving or not.

Few professionals look into or ask about how a mental illness changes the identity of the people living with it. Instead, clinicians focus on alleviating a patient’s symptoms, according to Logan.

“For many psychiatrists, mental disorders are medical problems to be treated with medications, and a patient’s crisis of self is not very likely to come up in a 15-minute session with a psychopharmacologist,” she said.

Logan has talked to clinicians about why issues involving identity were rarely brought up when treating patients for mental illness.

“For many people with mental disorders, the transformation of the self is one of the most disturbing things about being ill,” Logan said. “And their despair is heightened when doctors don’t engage with the issue, don’t ask about what parts of the self that have vanished and don’t help figure out strategies to deal with that loss.”

Some mental health professionals are starting to recognize this. Janina Fisher, a psychologist and the assistant director of the Sensorimotor Psychotherapy Institute in Broomfield, Colo., assured Logan that newer therapies and approaches to treatment have changed the way that most professionals view the role the self plays in treating mental disorders.

Fisher encourages her patients to accept the role of mental trauma in their lives, but avoid letting the presence of those issues rule their lives.